Performance of clinician prediction of survival in oncology outpatients with advanced cancer

Yu Jung Kim; Seok Joon Yoon; Sang Yeon Suh; Yusuke Hiratsuka; Beodeul Kang; Si Won Lee; Hong Yup Ahn; Koung Jin Suh; Ji Won Kim; Se Hyun Kim; Jin Won Kim; Keun Wook Lee; Jee Hyun Kim; Jong Seok Lee

doi:10.1371/journal.pone.0267467

Performance of clinician prediction of survival in oncology outpatients with advanced cancer

Yu Jung Kim
, Seok Joon Yoon
, Sang Yeon Suh
, Yusuke Hiratsuka
, Beodeul Kang
, Si Won Lee
, Hong Yup Ahn
, Koung Jin Suh
, Ji Won Kim
, Se Hyun Kim
, Jin Won Kim
, Keun Wook Lee
, Jee Hyun Kim
, Jong Seok Lee

Research output: Contribution to journal › Article › peer-review

10 Scopus citations

Abstract

Background We aimed to investigate the performance of clinician prediction of survival (CPS) and the association between CPS and the prognostic confidence of clinicians in ambulatory medical oncology outpatients. Methods Eight medical oncologists estimated the expected survival of their patients in a prospective cohort study. They were asked to provide a temporal type of CPS in weeks, together with their level of confidence for each prediction (0–100%). We analyzed the accuracy of CPS, the association between CPS and the prognostic confidence, and the characteristics of patients showing inaccurate CPS. Results A total of 200 advanced cancer patients were enrolled and the median overall survival was 7.6 months. CPS was accurate in 67 (33.5%) patients, underestimated in 87 (43.5%), and overestimated in 46 (23.0%). The overall accuracy of CPS for 12-week, 24-week, 36-week, and 48-week survival was 83.0%, 72.0%, 75.5%, and 74.0%, respectively. The specificity was highest for 12-week survival (90.2%) and the sensitivity was highest for 48-week survival (96.1%). The sensitivity of 12-week CPS was 51.4% and the area under the receiver operating characteristic (AUROC) curve was 0.79 (95% confidence interval [CI] 0.71–0.87). The prognostic confidence of clinicians was not significantly associated with the accuracy of prediction (P = 0.359). Patients with overestimated survival had significantly poorer global health status and physical/role/emotional functioning in the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQC30). Additionally, they showed significantly higher levels of fatigue, nausea/vomiting, pain, dyspnea, and loss of appetite. Conclusion The overall accuracy of CPS in predicting 12-week to 48-week survival was high in medical oncology outpatients. However the sensitivity of 12-week CPS was low and prognostic confidence was not associated with the accuracy of CPS. Patients with overestimated CPS showed poorer quality of life and higher symptom burden.

Original language	English
Article number	e0267467
Journal	PLoS ONE
Volume	17
Issue number	4 April
DOIs	https://doi.org/10.1371/journal.pone.0267467
State	Published - Apr 2022

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@article{97fad63936aa44bf8a8a760295d02dd8,

title = "Performance of clinician prediction of survival in oncology outpatients with advanced cancer",

abstract = "Background We aimed to investigate the performance of clinician prediction of survival (CPS) and the association between CPS and the prognostic confidence of clinicians in ambulatory medical oncology outpatients. Methods Eight medical oncologists estimated the expected survival of their patients in a prospective cohort study. They were asked to provide a temporal type of CPS in weeks, together with their level of confidence for each prediction (0–100\%). We analyzed the accuracy of CPS, the association between CPS and the prognostic confidence, and the characteristics of patients showing inaccurate CPS. Results A total of 200 advanced cancer patients were enrolled and the median overall survival was 7.6 months. CPS was accurate in 67 (33.5\%) patients, underestimated in 87 (43.5\%), and overestimated in 46 (23.0\%). The overall accuracy of CPS for 12-week, 24-week, 36-week, and 48-week survival was 83.0\%, 72.0\%, 75.5\%, and 74.0\%, respectively. The specificity was highest for 12-week survival (90.2\%) and the sensitivity was highest for 48-week survival (96.1\%). The sensitivity of 12-week CPS was 51.4\% and the area under the receiver operating characteristic (AUROC) curve was 0.79 (95\% confidence interval [CI] 0.71–0.87). The prognostic confidence of clinicians was not significantly associated with the accuracy of prediction (P = 0.359). Patients with overestimated survival had significantly poorer global health status and physical/role/emotional functioning in the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQC30). Additionally, they showed significantly higher levels of fatigue, nausea/vomiting, pain, dyspnea, and loss of appetite. Conclusion The overall accuracy of CPS in predicting 12-week to 48-week survival was high in medical oncology outpatients. However the sensitivity of 12-week CPS was low and prognostic confidence was not associated with the accuracy of CPS. Patients with overestimated CPS showed poorer quality of life and higher symptom burden.",

author = "Kim, \{Yu Jung\} and Yoon, \{Seok Joon\} and Suh, \{Sang Yeon\} and Yusuke Hiratsuka and Beodeul Kang and Lee, \{Si Won\} and Ahn, \{Hong Yup\} and Suh, \{Koung Jin\} and Kim, \{Ji Won\} and Kim, \{Se Hyun\} and Kim, \{Jin Won\} and Lee, \{Keun Wook\} and Kim, \{Jee Hyun\} and Lee, \{Jong Seok\}",

note = "Publisher Copyright: Copyright: {\textcopyright} 2022 Kim et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.",

year = "2022",

month = apr,

doi = "10.1371/journal.pone.0267467",

language = "English",

volume = "17",

journal = "PLoS ONE",

issn = "1932-6203",

publisher = "Public Library of Science",

number = "4 April",

}

TY - JOUR

T1 - Performance of clinician prediction of survival in oncology outpatients with advanced cancer

AU - Kim, Yu Jung

AU - Yoon, Seok Joon

AU - Suh, Sang Yeon

AU - Hiratsuka, Yusuke

AU - Kang, Beodeul

AU - Lee, Si Won

AU - Ahn, Hong Yup

AU - Suh, Koung Jin

AU - Kim, Ji Won

AU - Kim, Se Hyun

AU - Kim, Jin Won

AU - Lee, Keun Wook

AU - Kim, Jee Hyun

AU - Lee, Jong Seok

N1 - Publisher Copyright: Copyright: © 2022 Kim et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

PY - 2022/4

Y1 - 2022/4

N2 - Background We aimed to investigate the performance of clinician prediction of survival (CPS) and the association between CPS and the prognostic confidence of clinicians in ambulatory medical oncology outpatients. Methods Eight medical oncologists estimated the expected survival of their patients in a prospective cohort study. They were asked to provide a temporal type of CPS in weeks, together with their level of confidence for each prediction (0–100%). We analyzed the accuracy of CPS, the association between CPS and the prognostic confidence, and the characteristics of patients showing inaccurate CPS. Results A total of 200 advanced cancer patients were enrolled and the median overall survival was 7.6 months. CPS was accurate in 67 (33.5%) patients, underestimated in 87 (43.5%), and overestimated in 46 (23.0%). The overall accuracy of CPS for 12-week, 24-week, 36-week, and 48-week survival was 83.0%, 72.0%, 75.5%, and 74.0%, respectively. The specificity was highest for 12-week survival (90.2%) and the sensitivity was highest for 48-week survival (96.1%). The sensitivity of 12-week CPS was 51.4% and the area under the receiver operating characteristic (AUROC) curve was 0.79 (95% confidence interval [CI] 0.71–0.87). The prognostic confidence of clinicians was not significantly associated with the accuracy of prediction (P = 0.359). Patients with overestimated survival had significantly poorer global health status and physical/role/emotional functioning in the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQC30). Additionally, they showed significantly higher levels of fatigue, nausea/vomiting, pain, dyspnea, and loss of appetite. Conclusion The overall accuracy of CPS in predicting 12-week to 48-week survival was high in medical oncology outpatients. However the sensitivity of 12-week CPS was low and prognostic confidence was not associated with the accuracy of CPS. Patients with overestimated CPS showed poorer quality of life and higher symptom burden.

AB - Background We aimed to investigate the performance of clinician prediction of survival (CPS) and the association between CPS and the prognostic confidence of clinicians in ambulatory medical oncology outpatients. Methods Eight medical oncologists estimated the expected survival of their patients in a prospective cohort study. They were asked to provide a temporal type of CPS in weeks, together with their level of confidence for each prediction (0–100%). We analyzed the accuracy of CPS, the association between CPS and the prognostic confidence, and the characteristics of patients showing inaccurate CPS. Results A total of 200 advanced cancer patients were enrolled and the median overall survival was 7.6 months. CPS was accurate in 67 (33.5%) patients, underestimated in 87 (43.5%), and overestimated in 46 (23.0%). The overall accuracy of CPS for 12-week, 24-week, 36-week, and 48-week survival was 83.0%, 72.0%, 75.5%, and 74.0%, respectively. The specificity was highest for 12-week survival (90.2%) and the sensitivity was highest for 48-week survival (96.1%). The sensitivity of 12-week CPS was 51.4% and the area under the receiver operating characteristic (AUROC) curve was 0.79 (95% confidence interval [CI] 0.71–0.87). The prognostic confidence of clinicians was not significantly associated with the accuracy of prediction (P = 0.359). Patients with overestimated survival had significantly poorer global health status and physical/role/emotional functioning in the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQC30). Additionally, they showed significantly higher levels of fatigue, nausea/vomiting, pain, dyspnea, and loss of appetite. Conclusion The overall accuracy of CPS in predicting 12-week to 48-week survival was high in medical oncology outpatients. However the sensitivity of 12-week CPS was low and prognostic confidence was not associated with the accuracy of CPS. Patients with overestimated CPS showed poorer quality of life and higher symptom burden.

UR - https://www.scopus.com/pages/publications/85128613737

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DO - 10.1371/journal.pone.0267467

M3 - Article

C2 - 35446910

AN - SCOPUS:85128613737

SN - 1932-6203

VL - 17

JO - PLoS ONE

JF - PLoS ONE

IS - 4 April

M1 - e0267467

ER -

Performance of clinician prediction of survival in oncology outpatients with advanced cancer

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